Evaluation of cerebrovascular reactivity in chronic hepatitis C patients using transcranial color Doppler

Ivelja, Mirela Pavičić; Ivić, Ivo; Dolić, Krešimir; Meštrović, Antonio; Perković, Nikola; Janković, Stipan

doi:10.1371/journal.pone.0218206

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…Our study showed that cerebrovascular reactivity values, calculated as the BHI, were significantly lower in the HCV group than in the healthy control group. Similar results were obtained in our previous study which consisted only of ultrasound parameters, emphasising reduction of vasodilatatory capacity of the cerebral arteries in patients with chronic hepatitis C ( Pavicic Ivelja et al, 2019 ). The above mentioned findings suggest an unfavorable effect of chronic HCV infection on cerebrovascular hemodynamics and might lead to an increased risk of CVD.…”

Section: Discussionsupporting

confidence: 90%

“…Ultrasound data were collected as previously described in Pavicic Ivelja et al (2019) using transcranial color Doppler sonography (TCCD) which allows a rapid and non-invasive investigation of cerebral blood flow (CBF) velocities in the large cerebral arteries and velocity changes after a vasodilatory stimulus such as apnea. These changes, known as cerebrovascular reactivity, are considered an indicator of the capability of adaptive changes in CBF and can be reduced in patients under risk of CVD ( Markus & Harrison, 1992 ; Silvestrini et al, 1996 ; Apruzzese et al, 2001 ).…”

Section: Introductionmentioning

confidence: 99%

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Blood markers of endothelial dysfunction and their correlation to cerebrovascular reactivity in patients with chronic hepatitis C infection

Ivelja

Dolić

Tandara

et al. 2021

PeerJ

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Although liver cirrhosis and hepatocellular carcinoma are major consequences of hepatitis C (HCV), there has been an increasing number of studies examining extrahepatic manifestations, especially those caused by systemic chronic inflammation and metabolic complications that might predispose HCV patients to atherosclerosis and ischemic cerebrovascular disease (CVD). The aim of our study was to assess E-selectin, VCAM-1, ICAM-1 and VEGF-A serum levels in patients with chronic HCV infection and to correlate them with cerebrovascular reactivity. A blood sample was taken from eighteen patients with chronic hepatitis C infection and from the same number of healthy blood donors in the control group. The aim was to analyse markers of endothelial dysfunction and to correlate them with cerebrovascular reactivity expressed as breath-holding index (BHI) determined using transcranial color Doppler. The obtained results revealed significant differences between the groups in all endothelial markers except for the E selectin. While the ICAM-1 and sVCAM-1 were significantly increased in the hepatitis group, VEGF-A was significantly decreased. A significant reduction of 0.5 (95% CI 0.2, 0.8) in the mean BHI was found in the hepatitis group (mean BHI 0.64) compared to controls (mean BHI 1.10). No significant association between the BHI and any of the endothelial markers was found in the control group, while in the hepatitis group, the scatter plot of ICAM-1 vs BHI suggested that the association might be present. In conclusion, the results of this study confirm an association between a chronic HCV infection and altered cerebrovascular reactivity as well as higher levels of markers of endothelial activation (ICAM-1, VCAM-1) as possible indicators of an increased CVD risk.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Blood markers of endothelial dysfunction and their correlation to cerebrovascular reactivity in patients with chronic hepatitis C infection

Ivelja

Dolić

Tandara

et al. 2021

PeerJ

Self Cite

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“…Like other virus infections, the SARS-CoV-2 virus can cause severe endothelial dysfunction. Pavicic Ivelja et al found that chronic hepatitis C patients have altered cerebrovascular reactivity and these negative effects on cerebrovascular hemodynamics could contribute to the increased risk of cerebrovascular disease [ 30 ]. Chow et al found similar changes in patients with HIV infection and their cerebrovascular endothelial dysfunction may independently contribute to cognitive impairment [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Cerebral Vasoreactivity Evaluated by Transcranial Color Doppler and Breath-Holding Test in Patients after SARS-CoV-2 Infection

Marčić

Marcic

et al. 2021

JPM

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From the beginning of the SARS-CoV-2 virus pandemic, it was clear that the virus is highly neurotrophic. Neurological manifestations can range from nonspecific symptoms such as dizziness, headaches and olfactory disturbances to severe forms of neurological dysfunction. Some neurological complication can occur even after mild forms of respiratory disease. This study’s aims were to assess cerebrovascular reactivity in patients with nonspecific neurological symptoms after SARS-CoV-2 infection. A total of 25 patients, aged 33–62 years, who had nonspecific neurological symptoms after SARS-CoV-2 infection, as well as 25 healthy participants in the control group, were assessed for cerebrovascular reactivity according to transcranial color Doppler (TCCD) which we combined with a breath-holding test (BHT). In subjects after SARS-CoV-2 infection, there were statistically significantly lower flow velocities through the middle cerebral artery at rest period, lower maximum velocities at the end of the breath-holding period and lower breath holding index (BHI) in relation to the control group. Changes in cerebral artery flow rate velocities indicate poor cerebral vasoreactivity in the group after SARS-CoV-2 infection in regard to the control group and suggest vascular endothelial damage by the SARS-CoV-2 virus.

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“…Several studies have also considered the potential association between HCV infection and cerebrovascular events, finding contradictory results, ranging from HCV infection as a risk factor to HCV infection as a protective factor [142][143][144]. Despite the heterogeneity found among the studies included in a meta-analysis (made up of six studies, five retrospective and one prospective) published in 2013, results suggested that HCV infection increases the risk of stroke; with a random-effects model, the outcome was 1.58 (0.86, 2.30), which was improved after excluding the study that caused the heterogeneity, with a pooled odds ratio (OR) with a 95% CI equating to 1.97 (1.64, 2.30) [145]. A second meta-analysis, which included 8 studies, found that HCV-infected subjects kept an increased risk of cerebro-CV events (OR, 1.30; 95% CI, 1.10-1.55; P < 0.01) than uninfected subjects, with a stronger impact in those with higher CV risk (e.g., high incidence of T2D or hypertension) [15].…”

Section: Potential Mechanisms Linking Hcv To Atherosclerosismentioning

confidence: 99%

Viral infections in cardiometabolic risk and disease between old acquaintances and new enemies

Vassalle

2023

Explor Cardiol

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Atherosclerosis is a chronic disease, characterized by chronic inflammation, endothelial dysfunction, and lipid deposition in the vessel. Although many major, well-identified risk factors for atherosclerosis [e.g., hyperlipidemia, hypertension, type 2 diabetes (T2D), smoking habit, and obesity] explain a lot about the risk, there is a considerable number of patients who develop atherosclerotic damage and undergo adverse events without presenting any of these established modifiable risk factors. This observation has stimulated an urgent need to expand knowledge towards the identification of additional, less established risk factors that may help in the assessment of risk and fill the gap of knowledge in the cardiovascular (CV) setting. Among them, the hypothesis of a possible relationship between viral infectious agents and atherosclerosis has risen since the early 1900s. However, there is still a great deal of debate regarding the onset and progression of CV disease in relation to the roles of the pathogens (as active inducers or bystanders), host genomic counterparts, and environmental triggers, affecting both virus abundance and the composition of viral communities. Accordingly, the aim of this review is to discuss the current state of knowledge on infectious agents in the atherosclerotic process, with particular focus on two environmental-related viruses, as examples of familiar (influenza) and unfamiliar [severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)] disease triggers.

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Evaluation of cerebrovascular reactivity in chronic hepatitis C patients using transcranial color Doppler

Cited by 5 publications

References 33 publications

Blood markers of endothelial dysfunction and their correlation to cerebrovascular reactivity in patients with chronic hepatitis C infection

Blood markers of endothelial dysfunction and their correlation to cerebrovascular reactivity in patients with chronic hepatitis C infection

Cerebral Vasoreactivity Evaluated by Transcranial Color Doppler and Breath-Holding Test in Patients after SARS-CoV-2 Infection

Viral infections in cardiometabolic risk and disease between old acquaintances and new enemies

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